Cuban doctors follow an induction programme at the Kenya School of Government in June 2018 in Nairobi. Photo: AFP/SIMON MAINA

Defending a deal that brought100 Cuban doctors to work in Kenya, a top official in the presidency said the Cubans would boost the country’s low number of medics.

“Our doctor-to-patient ratio remains 1 doctor to every 16,000 patients,” Nzioka Waita, President Uhuru Kenyatta’s chief of staff, said ina statement a few days before the Cubans arrived.

This meant the country was “not anywhere near meeting the ratios required for the provision of quality healthcare to a majority of Kenyans”.

How was the number calculated?

The ratio came from comparing the total number of doctors to the total population, State House spokesman Manoah Esipisu told Africa Check. He did not provide the figures used in the calculation, however.

Was the government referring to the doctor-to-patient ratio or the doctor-to-population ratio? “It means the same, really,” Esipisu claimed.

But the dean of theSchool of Medicine atMoi University in Kenya, Prof Lukoye Atwoli, told Africa Check that “due to the difficulty approximating the number of patients at any given time, most reports will use the doctor-population ratio as a proxy for coverage”.

How many doctors does Kenya have?

The agency’slatest data – released in March 2018 – listed 6,394 actively practising Kenyan doctors. Of these, 2,591 were specialists. A further 939 were foreign doctors with temporary licenses, bringing the total to 7,333.

Kenya’s national statistics office puts thecountry’s population at 46.6 million people for 2017. Dividing this by 7,333 doctors results in a ratio of one doctor for every 6,355 people – not 16,000.

(Note: The board had put the doctor-to-population ratio at 1 to 6,545 based on a population of “approximately” 48 million. We asked for the source of the population figure and will update this report with the board’s response.)

‘A flawed metric’

“Unfortunately, [the doctor-to-population ratio] is a flawed metric,” Atwoli said. The ratio doesn’t reflect the geographical spread of doctors or whether they are in private of public practice. And not all doctors are able to provide the same service, as some may be specialists.

Lukoye, who is also the vice-president of the Kenya Medical Association, added that an “interesting metric” would be to rather examine “the proportion of patients requiring medical services who actually get to see a doctor, or those with conditions requiring specialised care who actually get to see a specialist”.

Does the World Health Organisation recommend a specific ratio?

There arefrequentreferences to a World Health Organisation recommendation that Kenya have one doctor for every 1,000 people by 2015.

But the UN agency told Africa Check that it does not prescribe a specific ratio.

“There is no current recommendation for a predefined physician to population ratio,” Dr Mathieu Boniol, a WHO statistician, said.

Conclusion: Data shows claim by top official in presidency that one doctor treats 16,000 Kenyans is incorrect

In defending the Kenyan government’s decision to enlist doctors from Cuba, President Uhuru Kenyatta’s Chief of Staff Nzioka Waita claimed that one doctor serves 16,000, and said this was a long way off a “required ratio”.

Data from the country’s medical board shows that the current proportion is one doctor for every 6,355 people.

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